Abstract:
extubation in COVID-19 patients and
the use of noninvasive ventilation in the
weaning process.
Methods: This retrospective,
observational, single-center study was
conducted in COVID-19 patients aged
18 years or older who were admitted
to an intensive care unit between April
2020 and December 2021, placed under
mechanical ventilation for more than 48
hours and progressed to weaning. Early
extubation was defined as extubation
without a spontaneous breathing trial
and immediate use of noninvasive
ventilation after extubation. In patients
who underwent a spontaneous breathing
trial, noninvasive ventilation could
be used as prophylactic ventilatory
assistance when started immediately after
extubation (prophylactic noninvasive
ventilation) or as rescue therapy in cases
of postextubation respiratory failure
(therapeutic noninvasive ventilation). The primary outcome was extubation
failure during the intensive care unit stay.
Results: Three hundred eightyfour extubated patients were included.
Extubation failure was observed in
107 (27.9%) patients. Forty-seven
(12.2%) patients received prophylactic
noninvasive ventilation. In 26 (6.8%)
patients, early extubation was performed
with immediate use of noninvasive
ventilation. Noninvasive ventilation
for the management of postextubation
respiratory failure was administered to
64 (16.7%) patients.
Conclusion: We found that
COVID-19 patients had a high rate
of extubation failure. Despite the high
risk of extubation failure, we observed
low use of prophylactic noninvasive
ventilation in these patients.
